Whole Health in VA Mental Health: A Randomized Controlled Trial of Omnis Salutis

退伍军人管理局心理健康的整体健康：Omnis Salutis 的随机对照试验

• 批准号: 10734056
• 负责人: Samantha Hack
• 金额: --
• 依托单位: VA EASTERN COLORADO HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-11-01 至 2026-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10734056
• 关键词: Afghanistan; Alcohol abuse; Anxiety; Anxiety Disorders; Appointment; Area; Caring; Cladribine; Communication; Communities; Complementary Health; Confusion; Data; Depressed mood; Depressive disorder; Diagnosis; Disease; Disease Management; District of Columbia; Dose; Dropout; Educational process of instructing; Electronic Health Record; Emotional; Equipment and supply inventories; Evaluation; Evidence based practice; Family; Fatigue; Feeling suicidal; Freedom; Frustration; Gender; Goals; Health; Health Services; Health Surveys; Healthcare; Healthcare Systems; Homelessness; Impairment; Integrative Medicine; Intervention; Iraq; Learning; Life; Link; Maryland; Mediating; Medical center; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Mission; Modeling; Outcome; Pain; Participant; Patient-Centered Care; Personal Satisfaction; Persons; Physical Function; Post-Traumatic Stress Disorders; Process; Provider; Psyche structure; Race; Randomized; Randomized, Controlled Trials; Recommendation; Reporting; Research; Research Methodology; Research Personnel; Research Support; Role; Running; Sampling; Self Care; Self Efficacy; Services; Site; Social Functioning; Social Network; Social support; Societies; Stress; Substance Use Disorder; Suicide attempt; Surveys; Symptoms; System; Telephone; Testing; Time; Unemployment; Veterans; Well in self; West Virginia; active control; aspirate; care systems; clinical encounter; community based participatory research; community involvement; community reintegration; efficacy evaluation; efficacy testing; experience; falls; follow-up; functional disability; functional improvement; healing; health care settings; health goals; health service use; improved; improved outcome; mental function; military operation; operation; patient oriented; person centered; physical conditioning; primary care setting; programs; recruit; secondary analysis; skill acquisition; skills; social relationships; stress related disorder; suicide rate; tailored health care; telehealth; whole health

Anticipated Impacts on Veteran Healthcare: Recent Veterans of the Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn (OIF/OEF/OND) conflicts are presenting in VA care with high rates of stress related mental health disorders (posttraumatic stress disorder, depression, anxiety, and alcohol abuse), and reporting significant difficulties with social relationships and community reintegration. Surveys of recent Veterans show that Veterans want the VA to provide mental health care tailored to their concerns and reintegration priorities; while simultaneously, the VA has committed to transforming to a Whole Health patient- centered, system of care. Within this context, Omnis Salutis, a brief, Veteran-focused, Whole Health activation intervention, was developed with a stakeholder advisory panel of Veterans, clinicians, and researchers. Preliminary findings indicate that participation in Omnis Salutis was associated with improvements in physical, mental and social functioning among recent Veterans with stress related mental health disorders. Project Background: The term “recent Veterans” refers to Veterans who served in the OIF/OEF/OND military operations. Almost 60% (708,062) of recent Veterans who received VA care have been diagnosed with a mental health disorder, most commonly post-traumatic stress disorder (56%), depressive disorders (45%), anxiety disorders (44%), and substance use disorders (21%). Recent Veterans with stress-related mental health disorders experience impairment in functional domains of health (overcoming and managing disease), purpose (meaningful daily activities and participation in society), and community (positive relationships and social networks). Omnis Salutis is a three-session intervention in which Veterans learn about Whole Health and complete a brief Personal Health Inventory, practice creating and delivering MY MAP (Mission/Aspiration/Purpose) to communicate their health mission consistently to their providers and social supports; and identify both formal and informal healing relationships that support their health mission. Omnis Salutis was shown to be acceptable to and feasible in a previous small randomized controlled trial (n = 48). Additionally, analyses of the relationship between participation in Omnis Salutis and outcomes on the Veterans RAND 36-Item Health Survey found a large effect for Bodily Pain improvement, medium effect size for Social Functioning, small effect sizes for Physical Functioning, Emotional Well-Being, Energy/Fatigue, Role Limitations due to Emotional Problems, and General Health. These results are very promising and support further testing of Omnis Salutis. Project Objectives: The proposed research will test the efficacy of Omnis Salutis, a brief, Veteran-focused, Whole Health activation intervention, in a randomized controlled trial (n = 238). The primary aim of the study is to evaluate the efficacy of Omnis Salutis for improving the physical and social functioning of recent Veterans with stress-related disorders. The secondary aim is to evaluate the efficacy of Omnis Salutis for increasing Veteran engagement in care for stress-related disorders. There is an exploratory aim to Evaluate the processes that underlie the relationship between engagement in care and functioning. This study will provide support for Omnis Salutis as an evidence-based practice and for broader dissemination. Project Methods: We propose a randomized controlled trial in a sample of 238 Veterans with stress-related mental health disorders recruited from four VA medical centers in Maryland, Washington DC, and West Virginia. Veterans will be randomly assigned to receive three sessions of Omnis Salutis or three sessions of an active control, health, and wellness intervention. Both conditions will be delivered via as VA Video Connect (VVC) telehealth platform or telephone. Participants will complete assessments at baseline, 3-month follow-up, 6-month follow-up, and 12-month follow-up timepoints. Analyses will examine differences in change over time between the two intervention conditions.

对退伍军人医疗保健的预期影响：持久自由行动的最近退伍军人， 伊拉克自由和新黎明行动（OIF/OEF/OND）的冲突在VA护理中呈现出高比率， 压力相关的心理健康障碍（创伤后压力障碍、抑郁、焦虑和酗酒）， 并报告在社会关系和重返社区方面存在重大困难。最近的调查 退伍军人表明，退伍军人希望退伍军人事务部提供适合他们的关注的心理健康护理， 重返社会的优先事项;同时，VA致力于转变为全健康患者- 以人为本的护理体系在这种情况下，Omnis Salutis，一个简短的，以退伍军人为重点的，整体健康激活 干预，是由退伍军人，临床医生和研究人员组成的利益相关者咨询小组开发的。 初步研究结果表明，参与Omnis Salutis与身体， 心理和社会功能在最近的退伍军人与压力有关的心理健康障碍。 项目背景：“新近退伍军人”一词是指曾在法语国家组织/持久自由行动/民主国家组织军队服役的退伍军人。 运营近60%（708，062）最近接受VA护理的退伍军人被诊断患有 精神健康障碍，最常见的创伤后应激障碍（56%），抑郁症（45%）， 焦虑症（44%）和物质使用障碍（21%）。最近退伍军人与压力有关的精神 健康障碍在健康功能领域（克服和管理疾病）受到损害， 目的（有意义的日常活动和参与社会）和社区（积极的关系和 社交网络）。Omnis Salutis是一个三次会议的干预，退伍军人了解整体健康 并完成一份简短的个人健康清单，练习创建和提供我的地图 （使命/愿望/目的）将其健康使命始终如一地传达给其提供者和社会 支持;并确定正式和非正式的愈合关系，支持他们的健康使命。Omnis 在先前的小型随机对照试验（n = 48）中，Salutis被证明是可接受的和可行的。 此外，分析参与Omnis Salutis和退伍军人结果之间的关系， 兰德36项健康调查发现，对身体疼痛改善有较大影响，对社会影响中等 功能，身体功能、情绪健康、能量/疲劳、角色的小效应量 由于情绪问题和一般健康的限制。这些结果是非常有希望和支持 对奥姆尼斯·萨劳蒂斯的进一步测试 项目目标：拟议的研究将测试Omnis Salutis的有效性，一个简短的，退伍军人为重点， 整体健康激活干预，在一项随机对照试验中（n = 238）。这项研究的主要目的是 评估Omnis Salutis改善近期退伍军人身体和社会功能的功效 与压力有关的疾病第二个目的是评估Omnis Salutis增加 退伍军人参与护理与压力有关的疾病。有一个探索性的目的是评估 参与护理和功能之间关系的基础过程。本研究将提供 支持将“一切有益”作为一种循证做法，并支持更广泛的传播。 项目方法：我们提出了一项随机对照试验，在238名退伍军人的样本与压力相关 从位于马里兰州、华盛顿和西弗吉尼亚州的四个退伍军人医疗中心招募的精神健康障碍患者 弗吉尼亚退伍军人将被随机分配接受三次Omnis Salutis治疗或三次 主动控制、健康和健康干预。这两种情况都将通过VA视频连接提供 (VVC)远程保健平台或电话。参与者将在基线、3个月随访、 6-个月随访和12个月随访时间点。分析将检查随时间变化的差异 在两种干预条件之间。